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Resumen Introducci車n El centellograma 車seo con 99mTc-MDP es una t谷cnica 迆til en el diagn車stico de osteomielitis, sin embargo, presenta especificidad limitada en presencia de patolog赤a 車sea previa (osteomielitis complicada). La 99mTc-ciprofloxacina es uno de los radiof芍rmacos m芍s difundidos para la detecci車n de infecciones 車seas, aunque persisten controversias sobre su rendimiento diagn車stico. Objetivo Determinar el valor cl赤nico del protocolo combinado de centellograma con 99mTc-ciprofloxacina y 99mTc-MDP en el diagn車stico de osteomielitis complicada y pr車tesis articular infectada. Materiales y m谷todos 37 pacientes con sospecha cl赤nica de osteomielitis complicada o pr車tesis infectada fueron estudiados mediante centellograma con 99mTc-ciprofloxacina y 99mTc-MDP. 26/37 pacientes presentaban fractura previa, 7 pr車tesis de rodilla y 4 pr車tesis de cadera. En todos ellos se realiz車 seguimiento cl赤nico y bacteriol車gico. Resultados El m谷todo present車 sensibilidad de 94%, especificidad de 79%, valor predictivo positivo de 81% y valor predictivo negativo de 94%, con una exactitud de 86%. Conclusiones El protocolo combinado de 99mTc-ciprofloxacina y 99mTc-MDP presenta elevado rendimiento para el diagn車stico de osteomielitis complicada y pr車tesis articular infectada. AbstractIntroduction Bone scintigraphy with 99mTc-MDP is a useful technique in the diagnosis of osteomyelitis, however, has limited specificity in the presence of previous bone pathology (complicated osteomyelitis). 99mTc-ciprofloxacin is one of the most widely used radiotracers for the detection of bone infection, although controversies persist on its diagnostic performance. Objective To determine the clinical value of 99mTc-ciprofloxacin/99mTc-MDP combined protocol in the diagnosis of complicated osteomyelitis and infected joint prosthesis. Materials and methods 37 patients with clinically suspected complicated osteomyelitis or infected prosthesis were studied with 99mTc-ciprofloxacin and 99mTc-MDP scintigraphy. 26/37 patients had previous fractures, 7 had knee replacements and 4 had hip replacements. All of the patients underwent clinical and bacteriological follow-up. Results The method presented sensitivity of 94%, 79% specificity, 81% positive predictive value and 94% negative predictive value, with an accuracy of 86%. Conclusions The combined protocol using 99mTc-ciprofloxacin/99mTc-MDP showed high diagnostic performance in complicated osteomyelitis and infected joint prosthesis.
